Medical Assistant Pamela Madrano takes the blood pressure and heart rate of Berlin Heineken, 6, of Brookfield, during a check-up at Doctors Express Urgent Care in Danbury, Conn. Wednesday, Aug. 20, 2014. The clinic is among a select few in the state that has a doctor specialized to give physicals approved by United States Citizenship and Immigration Services for immigrants applying for U.S. citizenship. less

Medical Assistant Pamela Madrano helps Rhiannon Heineken, of Brookfield, and her daughters Berlin, center, 6, and Danika, 7, at Doctors Express Urgent Care in Danbury, Conn. Wednesday, Aug. 20, 2014. The clinic is among a select few in the state that has a doctor specialized to give physicals approved by United States Citizenship and Immigration Services for immigrants applying for U.S. citizenship. less

Rhiannon Heineken, of Brookfield, and her daughter Danika Heineken, 7, wait for the results of a blood pressure and heart rate test at Doctors Express Urgent Care in Danbury, Conn. Wednesday, Aug. 20, 2014. The clinic is among a select few in the state that has a doctor specialized to give physicals approved by United States Citizenship and Immigration Services for immigrants applying for U.S. citizenship. less

Rhiannon Heineken, of Brookfield, and her daughter Danika Heineken, 7, wait for the results of a blood pressure and heart rate test at Doctors Express Urgent Care in Danbury, Conn. Wednesday, Aug. 20, 2014. ... more

Medical Assistant Pamela Madrano assists Rhiannon Heineken, of Brookfield, during a check-up at Doctors Express Urgent Care in Danbury, Conn. Wednesday, Aug. 20, 2014. The clinic is among a select few in the state that has a doctor specialized to give physicals approved by United States Citizenship and Immigration Services for immigrants applying for U.S. citizenship. less

Medical Assistant Pamela Madrano assists Rhiannon Heineken, of Brookfield, during a check-up at Doctors Express Urgent Care in Danbury, Conn. Wednesday, Aug. 20, 2014. The clinic is among a select few in the ... more

Medical Assistant Pamela Madrano takes the blood pressure and heart rate of Danika Heineken, 7, of Brookfield, during a check-up at Doctors Express Urgent Care in Danbury, Conn. Wednesday, Aug. 20, 2014. The clinic is among a select few in the state that has a doctor specialized to give physicals approved by United States Citizenship and Immigration Services for immigrants applying for U.S. citizenship. less

Berlin Heineken, 6, of Brookfield, gets her heart rate checked during a check-up at Doctors Express Urgent Care in Danbury, Conn. Wednesday, Aug. 20, 2014. The clinic is among a select few in the state that has a doctor specialized to give physicals approved by United States Citizenship and Immigration Services for immigrants applying for U.S. citizenship. less

Berlin Heineken, 6, of Brookfield, gets her heart rate checked during a check-up at Doctors Express Urgent Care in Danbury, Conn. Wednesday, Aug. 20, 2014. The clinic is among a select few in the state that ... more

Medical Assistant Pamela Madrano checks the height and weight of Berlin Heineken, 6, of Brookfield, during a check-up at Doctors Express Urgent Care in Danbury, Conn. Wednesday, Aug. 20, 2014. The clinic is among a select few in the state that has a doctor specialized to give physicals approved by United States Citizenship and Immigration Services for immigrants applying for U.S. citizenship. less

Medical Assistant Pamela Madrano checks the height and weight of Berlin Heineken, 6, of Brookfield, during a check-up at Doctors Express Urgent Care in Danbury, Conn. Wednesday, Aug. 20, 2014. The clinic is ... more

Rhiannon Heineken, of Brookfield, and her daughters Danika, center, 7, and Berlin, 6, wait at Doctors Express Urgent Care in Danbury, Conn. Wednesday, Aug. 20, 2014. The clinic is among a select few in the state that has a doctor specialized to give physicals approved by United States Citizenship and Immigration Services for immigrants applying for U.S. citizenship. less

Rhiannon Heineken, of Brookfield, and her daughters Danika, center, 7, and Berlin, 6, wait at Doctors Express Urgent Care in Danbury, Conn. Wednesday, Aug. 20, 2014. The clinic is among a select few in the ... more

In the past, the exam, known as an immigrant physical, was valid until an immigrant received a green card, a process that could take years. But now the exam will be valid for only one year after the exam.

Immigration advocates said the new rule adds another layer of bureaucracy to an already backlogged immigration process, besides being a financial hardship for immigrants who must shell out hundreds of dollars to retake the medical exam.

"The exam is overkill and a waste of time, and now the rule will make the whole immigration system slower," said Michael Boyle, an immigration attorney in Danbury.

Civil surgeons in the region said because of the new rule patients who passed the physical last year but had their immigration cases held up or were caught in a backlog are calling to schedule a new exam.

"We are seeing a lot of patients who we saw last year," said Allen Davis, a certified civil surgeon whose Newtown Road practice in Danbury caters to skilled immigrant workers seeking employer-sponsored green cards. Many of his patients work for companies such as GE and Boehringer Ingelheim.

The immigration physical is a lengthy and expensive health care process that requires bloodwork, X-rays and host of vaccinations. Only a handful of certified surgeons are located in the Greater Danbury area.

To a passerby, the Urgent Care Center on Main Street might look like a routine walk-in medical clinic. But on any week Thomas Brown, a physician at the center and a certified civil surgeon, performs at least five immigrant physicals.

"We are one of the last stops in the immigration process," said Brown, who has seen an increase in immigrants seeking immigrant physicals since the clinic opened last year.

Ana Patricia Echeverri, a certified civil surgeon in Danbury, hasn't seen a recent increase in immigrants seeking to take or retake the exam. But she is well aware of how slow the immigration process is.

"There are a lot of people in the dark waiting just waiting for their case to move along," she said.